| NPI | 1932843406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD229404) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 339590) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2026-07-21 |